Kevin Rudd (Griffith, Australian Labor Party, Prime Minister) Share this | Link to this | Hansard source

I move:

That this bill be now read a second time.

Earlier this year we opened up the doors of parliament to the people of Australia for the Australia 2020 Summit.

We did so looking for new ideas for our nation’s long term future—ideas for tackling the nation’s future challenges.

Many constructive ideas came forward, and later this year the government will be responding to each of them.

One of the key ideas discussed for the future of Australia’s health and hospitals system was to establish a national organ donation scheme.

And that is why today I introduce, with some pride, to the House the Australian Organ and Tissue Donation and Transplantation Authority Bill 2008to provide the national leadership that Australia needs to lift organ donation rates and make it possible for our expert transplant doctors and health professionals to save many more lives, and return many Australians to good health.

For too long, organ donation rates in Australia have lagged behind many other nations, despite high levels of community support for organ donation.

For too long, Australians have been left desperately waiting, month after month, for a transplant that could mean the difference between a normal, healthy life and debilitating chronic illness—and, in some cases, the difference between life and death.

For too long, people have talked about the need to lift organ donation rates but there has been no national leadership to take action on that goal.

And for too long, we have failed to act despite projections of a rising prevalence of chronic disease, an ageing population and, as a result, increased needs for organ transplants.

Last year, we made it clear that this government intends to end the blame game between the Commonwealth and the states and take responsibility for reforming our health and hospitals system.

That the government I would lead would get on with getting things right.

Today, the government delivers on that commitment.

Today, I stand before the House to move a bill that forms a central part of a national plan to reduce unnecessary suffering for thousands of Australians who are waiting for transplants.

Today, I move a bill that will help to honour our commitment to establishing Australia as a world leader for organ donation and transplantation.

Organ transplants in Australia

As Australians we are fortunate to live in a nation that has long been a world leader in the clinical outcomes we achieve for transplant patients—a nation where more than 90 per cent of people support organ donation.

Yet we are also a nation with a very long—far too long—waiting list for transplant procedures.

At any one time there are 1,800 Australians currently on waiting lists for an organ donation that could save or transform their life. 

Last year, there were just 198 deceased organ donors in Australia.

This resulted in 657 transplants—meeting just one-third of demand.

We should not tolerate so many Australians languishing on waiting lists for want of national leadership to lift organ donor rates.

Despite the high quality of clinical care across our nation, we lag well behind many other developed countries in organ donations.

The International Registry of Organ Donation and Transplantation reports that, in Australia, there were just 9.8 donors for every one million people in 2006.

In contrast:

• Spain had 33.8 donors for every one million persons—more than three times higher than Australia.
• The United States had 26.9 donors for every million persons—more than 2½ times the rate in Australia.

While Spain and the United States are world leaders respectively, Australia’s ranking for organ donors per million population was behind Belgium, Austria, France, Italy, Ireland, Hungary, Czech Republic, Norway, Germany, Sweden, Canada, Poland, the Netherlands, Argentina, Denmark, Switzerland and the UK.

We need to do much, much better.

This is simply not good enough—not for today, and especially not for the future.

In the decades ahead of us we will have an older population, and a population with a much higher incidence of chronic diseases such as obesity and type 2 diabetes.

Several of those chronic diseases can result in the need for a transplant.

Consider kidney disease.

More than three-quarters of people waiting for an organ transplant are in need of a kidney. 

Even now, one in three Australian adults face an elevated risk of developing chronic kidney disease. 

And the incidence of kidney disease is almost certain to rise further, because of its link to other chronic diseases.

Australia also has a high prevalence of hepatitis C infection.

Hepatitis C infection causes increased rates of chronic liver disease, resulting in a greater need for liver transplants.  

Reducing costly waiting lists

There are many other donor organs that are likely to be in greater need in the years ahead.

The long waiting list for transplants also imposes significant costs on our health and hospitals system.

For example, the cost for each person waiting on a kidney transplant is $83,000 per annum if they are receiving hospital based kidney dialysis.

In contrast, the cost of a kidney transplant is just $65,000 per recipient for the first year, and only $11,000 for each year thereafter.

Australians awaiting a transplant require extensive, expensive and time-consuming treatment.

That can make it harder for them to carry on work, to play an active role in their community and to enjoy a reasonable quality of life, all of which are important.

Lifting organ donor rates will help us build a more efficient health system and help sick Australians back to full participation in work and in the community.

Restoring healthy lives for recipients

But above all the reason why we must lift the number of organ donations is that, by doing this, we can help save and transform the lives of thousands of Australians of all ages.

Let me mention just one example.

A fortnight ago I informed the House that I had the privilege of meeting with Cordelia Whatman, her parents, big sister Octavia and grandparents.

Cordelia had just returned home to her family and to Canberra after four months in hospital. 

For those of you who are not familiar with Cordelia’s story, she was diagnosed with biliary artesia at 10 weeks.

Biliary artesia is a chronic liver problem that affects vital body functions.

Having undertaken an unsuccessful procedure in July 2007, Cordelia had been suffering from severe jaundice, a broken leg, lethargy, debilitation and inability to gain weight.

But just a few weeks ago, that all changed.

And it all changed for one reason—a donor organ became available to her.

The transplant operation was performed at the Children’s Hospital at Westmead in Sydney. Cordelia had a 13-doctor medical team, headed by Dr Albert Shun and Dr Michael Stormon. Each member of that team is to be congratulated.

Shortly after, Cordelia was discharged from hospital, the transplant operation a success.

Cordelia had to wait more than a year on a transplant waiting list.

During that long wait, Cordelia was becoming increasingly sick.

Indeed, the doctors had declared an operation urgent, and Cordelia’s mother was only days from providing a liver donation herself.

That operation could have placed her mother’s life at risk.

But it was made unnecessary when a donor organ finally became available.

Today, Cordelia can look forward to a healthy life—because of the selfless act of a donor and their family. And we thank them.

Cordelia’s donor also provided six other organs, potentially saving the lives of others with their decision.

In Australia today there are some 30,000 people who like Cordelia have benefited from an organ or tissue transplantation in this country.

We have some of these people with us here today, as well as some who are among the 1,800 now waiting for a transplant.

I would like particularly to acknowledge some of them who are with us today in the gallery:

Felix Bulmer, aged 17, who benefited from a corneal graft that has dramatically improved his vision; Russell McGowan, who has had a bone marrow transplant; Marjorie Taylor, the mother of Annette Taylor who expressed her wish to become an organ donor before her death at the age of just 13. Marjorie took it to then Prime Minister Whitlam to ensure that her daughter could go through with her wish—and so she became the first organ donor in the ACT.  That was more than 30 years ago.

These are just three of the 30,000 Australians who can tell a story of how an organ transplant can transform your life.

Transplantation makes it possible for people of all ages to enjoy those things that we too often take for granted—the ability to live free of debilitating disease, the ability to live a fit and active life, the ability to continue as a healthy member of their family and community.

The government is determined to make transplants possible for many more Australians.

And that is why—and that is the only reason why—this bill is before the House today.

A new nationally coordinated approach

When we look at the nations that have enjoyed most success with organ donor rates, we learn one clear lesson.

National leadership is needed to drive the change necessary to improve rates of organ donation.

The nations that lead the world in organ donation and transplantation rates all have national systems to coordinate and drive this program actively within each individual hospital.

Those national frameworks are supported by ongoing community and professional education.

The bill that comes before the House today reflects international best practice.

It forms a core part of the reform package that the government announced on 2 July this year, to lift Australia to world’s best practice in organ and tissue donation for transplantation.

The government has committed $151.1 million towards this objective, including $136.4 million in new funds. This is not cheap. To do it well takes money, and we are determined to invest this money.

And this package was endorsed by the Council of Australian Governments when it met on 3 July.

The national plan consists of five key steps:

1. $46 million to introduce a coordinated, consistent approach and systems under the leadership of a new, independent national authority—the Australian Organ Donation and Transplantation Authority—that is established under the bill that is before the House today.

2. $67 million to employ trained medical specialists and other staff dedicated to organ donation who will work closely with emergency department and intensive care unit teams in selected public and private hospitals across Australia.

3. $17 million in new funding for hospitals to meet additional staffing, bed and infrastructure costs associated with organ donation.

4. $13.4 million towards raising community awareness and building public confidence in Australia’s donation for a transplantation system.

5. $1.9 million for counsellors to support donor families.

This is a comprehensive plan, based on international best practice, that aims in the long term to establish Australia as a world leader in organ donation for transplantation.

It will mean that:

• potential donors are properly identified at hospitals across the country;
• every family of a potential donor will be asked about organ donation;
• a dedicated specialist will work with the potential donor and their family to provide support through what is often a very, very difficult process;
• hospital staff will be able to focus on donor care knowing that the hospital has a separate budget to cover organ and tissue donation;
• families receive the support they need at the time of organ donation and afterwards; and
• there is an equitable and safe process for managing transplant waiting lists and allocating organs once they become available.

One of the most important parts of this plan is to tackle the point at which our organ donor system is currently failing.

That is in the emergency wards and intensive care units of our hospitals.

Currently—and this is the core, practical problem—we do not have dedicated staff trained to help families through the difficult circumstances which they confront at that point and under which they may consent.

And with the pressures placed on our hospitals—and they are great—it is often difficult for clinicians to have these sensitive and delicate conversations with the families of potential donors.

This problem is compounded by the lack of dedicated hospital resources to manage the clinical procedures necessary for an organ or tissue transplant.

This explains why, despite an increase of one million in the number of organ donor registrations since 2002 to a total of six million registrations, there has been no increase in the number of lives being saved through transplants. That is what we are trying to solve and deal with through this legislation.

The majority of resources in the national plan will be dedicated to addressing this particular practical problem.

The Organ Donation and Transplantation Authority

The Australian Organ Donation and Transplantation Authority will work with states, territories, clinicians, consumers and the community sector to build a world leading system for Australia. 

The authority will:

• coordinate clinicians and other hospital staff dedicated to organ and tissue donation in hospitals across the country;
• train professional staff to do that;
• oversee a new national network of state and territory organ and tissue donation agencies;
• introduce and manage a national data and reporting system;
• lead ongoing community awareness programs about organ and tissue donation and transplantation; and
• work with clinical and professional organisations in developing clinical practice protocols and standards.

The authority will enable all families of potential donors to be asked about donation.

It will work with clinicians, hospitals and community organisations to educate people about donation, support families through this decision, and make sure that suitable patients will be considered as potential donors.

It will encourage Australians to discuss their wishes with their family—it is a very difficult conversation to have—and provide every family of a potential donor the information, knowledge and support to choose donation.

And, as a matter of reassurance, I note that the bill before the House today will in no way impede or restrict existing regulations for ensuring the safety of organ or tissue transplants.

Recent progress

Since making the announcement earlier this year, the government is getting on with the task of putting this system into practice.

All state and territory governments have signed up to the best practice national plan—and I thank them for it. Each of the states is working under the leadership of the Commonwealth Chief Medical Officer to implement this plan.

Work is on track to establish the national authority by 1 January 2009.

The positions of CEO and Medical Director of the new authority have been advertised.

Recruitment for new medical and nursing jobs in hospitals will commence as soon as possible.

Preparation for a national community awareness campaign for launch in early 2009 is underway.

Conclusion

I would like to conclude my remarks on this bill with a few additional points.

First, I would like to thank those organ donors and the members of families who have lost loved ones and who have assisted at a time of great personal distress and difficulty for them.

Second, I would like to say thank you to the organisations that have played such an important role in promoting awareness of the importance of organ donation and who have helped the development of the government’s national plan:

• The Transplantation Society of Australia and New Zealand;
• The Cognate Committee on Organ and Tissue Donation;
• Transplant Australia;
• Gift of Life;
• Zaidee’s Foundation; and
• ShareLife.

I would also like to acknowledge the contribution from the Chief Medical Officer, John Horvath, as well as Jane Halton, the Secretary of the Department of Health and Ageing.

Third, on a personal level as the recipient of a tissue transplant some years ago, I want to place on record my own debt of gratitude to the doctors, the health professionals and the community that has promoted organ and tissue transplants for so many years.

Finally, I would like to make an appeal to all Australians.

If you are not now on the organ donor list, please think about it and get your name on to it. Maybe that is a practical challenge for us all here: to make sure in the next few weeks that every member of this House and of the other place has made sure that they have made that decision with their family.

I would also make this appeal to the nation’s media: get behind this particular proposal. I thank the media for the work that they have already done. I have noticed that whenever our friends in the media get behind this, and we have good and positive stories of successful transplants, one thing happens: effective donation rates go up. This is a critical piece in the jigsaw. I thank the media for what they have done and I encourage them to continue to do it into the future. It really does help.

I appeal to all Australians to talk to their family about this matter. Your family makes critical choices if ever the day arrives when it might be your organs that can save the lives of others.

It is an extraordinary gift of an individual and their family, made in often very tragic circumstances.

Lifting the level of organ transplants in Australia requires a cooperative and concentrated effort from the Australian government, from state and territory governments, from health professionals, from community organisations and most of all from the whole Australian community.

This bill is a major step forward in coordinating our nation’s efforts to save lives and restore quality of life for thousands of Australians.

I thank the officials for their work in preparing this bill, given that I have been more than usually demanding in making sure that this bill was ready on time. I thank them for it, because they have really worked up against it.

So my challenge to the nation is: let’s get on with it.

I commend the bill to the House.

Malcolm Turnbull (Wentworth, Liberal Party, Shadow Treasurer) Share this | Link to this | Hansard source

I move:

That the debate be adjourned.

In moving that the debate be adjourned on the Australian Organ and Tissue Donation and Transplantation Authority Bill 2008, and on indulgence, I congratulate the Prime Minister for bringing forward this bill. The coalition strongly supports the objectives of this bill. Promoting organ donation is a vital national objective. It is something we pursued when we were in government. We are delighted that it is being pursued with new measures under this government, and the Prime Minister can count on our support on this legislation and on other measures in the future. If this legislation proves to be inadequate, we will continue to work in a genuine bipartisan fashion to promote organ donation. Very briefly, on behalf of the opposition I add my encouragement to the media to promote organ donation. Awareness is absolutely vital. I acknowledge, too, the generosity and the courage of organ donors and their families and the powerful advocacy of the organisations that have promoted awareness throughout the community. They have done great work and, again, we are delighted to support this legislation.

Question agreed to.